|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,282.56
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$779.61 |
| Max. Negotiated Rate |
$2,954.30 |
| Rate for Payer: Aetna Commercial |
$2,790.18
|
| Rate for Payer: Aetna Medicare |
$853.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,025.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,025.80
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$820.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,552.19
|
| Rate for Payer: BCN Commercial |
$2,552.19
|
| Rate for Payer: BCN Medicare Advantage |
$820.64
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cofinity Commercial |
$2,823.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.64
|
| Rate for Payer: Healthscope Commercial |
$2,954.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,461.92
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$861.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$943.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,790.18
|
| Rate for Payer: PACE Senior Care Partners |
$779.61
|
| Rate for Payer: PACE SWMI |
$820.64
|
| Rate for Payer: PHP Commercial |
$2,790.18
|
| Rate for Payer: PHP Medicare Advantage |
$820.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,855.83
|
| Rate for Payer: Priority Health Medicare |
$820.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,002.03
|
| Rate for Payer: Railroad Medicare Medicare |
$820.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,888.65
|
| Rate for Payer: UHC Core |
$2,740.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$820.64
|
| Rate for Payer: UHC Medicare Advantage |
$845.26
|
| Rate for Payer: VA VA |
$820.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,461.92
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,282.56
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,002.03 |
| Max. Negotiated Rate |
$2,954.30 |
| Rate for Payer: Aetna Commercial |
$2,790.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,536.76
|
| Rate for Payer: BCN Commercial |
$2,536.76
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cofinity Commercial |
$2,823.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.05
|
| Rate for Payer: Healthscope Commercial |
$2,954.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,461.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,790.18
|
| Rate for Payer: PHP Commercial |
$2,790.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,855.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,002.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,888.65
|
| Rate for Payer: UHC Core |
$2,740.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,461.92
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,282.56
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$779.61 |
| Max. Negotiated Rate |
$2,954.30 |
| Rate for Payer: Aetna Commercial |
$2,790.18
|
| Rate for Payer: Aetna Medicare |
$853.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,025.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,025.80
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$820.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,552.19
|
| Rate for Payer: BCN Commercial |
$2,552.19
|
| Rate for Payer: BCN Medicare Advantage |
$820.64
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cofinity Commercial |
$2,823.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.64
|
| Rate for Payer: Healthscope Commercial |
$2,954.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,461.92
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$861.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$943.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,790.18
|
| Rate for Payer: PACE Senior Care Partners |
$779.61
|
| Rate for Payer: PACE SWMI |
$820.64
|
| Rate for Payer: PHP Commercial |
$2,790.18
|
| Rate for Payer: PHP Medicare Advantage |
$820.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,855.83
|
| Rate for Payer: Priority Health Medicare |
$820.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,002.03
|
| Rate for Payer: Railroad Medicare Medicare |
$820.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,888.65
|
| Rate for Payer: UHC Core |
$2,740.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$820.64
|
| Rate for Payer: UHC Medicare Advantage |
$845.26
|
| Rate for Payer: VA VA |
$820.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,461.92
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$8,255.44
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,034.99 |
| Max. Negotiated Rate |
$7,429.90 |
| Rate for Payer: Aetna Commercial |
$7,017.12
|
| Rate for Payer: BCBS Trust/PPO |
$6,379.80
|
| Rate for Payer: BCN Commercial |
$6,379.80
|
| Rate for Payer: Cash Price |
$6,604.35
|
| Rate for Payer: Cofinity Commercial |
$7,099.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,604.35
|
| Rate for Payer: Healthscope Commercial |
$7,429.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,191.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,017.12
|
| Rate for Payer: PHP Commercial |
$7,017.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,778.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,182.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,034.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,264.79
|
| Rate for Payer: UHC Core |
$6,893.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,191.58
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$8,255.44
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,960.67 |
| Max. Negotiated Rate |
$7,429.90 |
| Rate for Payer: Aetna Commercial |
$7,017.12
|
| Rate for Payer: Aetna Medicare |
$2,146.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,579.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,579.82
|
| Rate for Payer: BCBS Complete |
$3,302.18
|
| Rate for Payer: BCBS MAPPO |
$2,063.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,418.60
|
| Rate for Payer: BCN Commercial |
$6,418.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,063.86
|
| Rate for Payer: Cash Price |
$6,604.35
|
| Rate for Payer: Cofinity Commercial |
$7,099.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,604.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,063.86
|
| Rate for Payer: Healthscope Commercial |
$7,429.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,191.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,167.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,373.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,017.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,960.67
|
| Rate for Payer: PACE SWMI |
$2,063.86
|
| Rate for Payer: PHP Commercial |
$7,017.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,063.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,778.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,182.23
|
| Rate for Payer: Priority Health Medicare |
$2,063.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,034.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,063.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,264.79
|
| Rate for Payer: UHC Core |
$6,893.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,063.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,125.78
|
| Rate for Payer: VA VA |
$2,063.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,191.58
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,277.07
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,253.30 |
| Max. Negotiated Rate |
$4,749.36 |
| Rate for Payer: Aetna Commercial |
$4,485.51
|
| Rate for Payer: Aetna Medicare |
$1,372.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,649.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,649.08
|
| Rate for Payer: BCBS Complete |
$2,110.83
|
| Rate for Payer: BCBS MAPPO |
$1,319.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,102.92
|
| Rate for Payer: BCN Commercial |
$4,102.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.27
|
| Rate for Payer: Cash Price |
$4,221.66
|
| Rate for Payer: Cofinity Commercial |
$4,538.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,221.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.27
|
| Rate for Payer: Healthscope Commercial |
$4,749.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,957.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,385.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,517.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,485.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,253.30
|
| Rate for Payer: PACE SWMI |
$1,319.27
|
| Rate for Payer: PHP Commercial |
$4,485.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,693.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,591.05
|
| Rate for Payer: Priority Health Medicare |
$1,319.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,218.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,319.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,643.82
|
| Rate for Payer: UHC Core |
$4,406.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,358.85
|
| Rate for Payer: VA VA |
$1,319.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,957.80
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,277.07
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,218.48 |
| Max. Negotiated Rate |
$4,749.36 |
| Rate for Payer: Aetna Commercial |
$4,485.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,078.12
|
| Rate for Payer: BCN Commercial |
$4,078.12
|
| Rate for Payer: Cash Price |
$4,221.66
|
| Rate for Payer: Cofinity Commercial |
$4,538.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,221.66
|
| Rate for Payer: Healthscope Commercial |
$4,749.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,957.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,485.51
|
| Rate for Payer: PHP Commercial |
$4,485.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,693.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,591.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,218.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,643.82
|
| Rate for Payer: UHC Core |
$4,406.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,957.80
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
OP
|
$617.10
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.56 |
| Max. Negotiated Rate |
$555.39 |
| Rate for Payer: Aetna Commercial |
$524.54
|
| Rate for Payer: Aetna Medicare |
$160.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.84
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$154.28
|
| Rate for Payer: BCBS Trust/PPO |
$479.80
|
| Rate for Payer: BCN Commercial |
$479.80
|
| Rate for Payer: BCN Medicare Advantage |
$154.28
|
| Rate for Payer: Cash Price |
$493.68
|
| Rate for Payer: Cash Price |
$493.68
|
| Rate for Payer: Cofinity Commercial |
$530.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$493.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.28
|
| Rate for Payer: Healthscope Commercial |
$555.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.82
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$524.54
|
| Rate for Payer: PACE Senior Care Partners |
$146.56
|
| Rate for Payer: PACE SWMI |
$154.28
|
| Rate for Payer: PHP Commercial |
$524.54
|
| Rate for Payer: PHP Medicare Advantage |
$154.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.88
|
| Rate for Payer: Priority Health Medicare |
$154.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.37
|
| Rate for Payer: Railroad Medicare Medicare |
$154.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.05
|
| Rate for Payer: UHC Core |
$515.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.28
|
| Rate for Payer: UHC Medicare Advantage |
$158.90
|
| Rate for Payer: VA VA |
$154.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.82
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
IP
|
$617.10
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$555.39 |
| Rate for Payer: Aetna Commercial |
$524.54
|
| Rate for Payer: BCBS Trust/PPO |
$476.89
|
| Rate for Payer: BCN Commercial |
$476.89
|
| Rate for Payer: Cash Price |
$493.68
|
| Rate for Payer: Cofinity Commercial |
$530.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$493.68
|
| Rate for Payer: Healthscope Commercial |
$555.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$524.54
|
| Rate for Payer: PHP Commercial |
$524.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.05
|
| Rate for Payer: UHC Core |
$515.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.82
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
IP
|
$413.27
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.05 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: BCBS Trust/PPO |
$319.38
|
| Rate for Payer: BCN Commercial |
$319.38
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.68
|
| Rate for Payer: UHC Core |
$345.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
OP
|
$413.27
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.15 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: Aetna Medicare |
$107.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.15
|
| Rate for Payer: BCBS Complete |
$165.31
|
| Rate for Payer: BCBS MAPPO |
$103.32
|
| Rate for Payer: BCBS Trust/PPO |
$321.32
|
| Rate for Payer: BCN Commercial |
$321.32
|
| Rate for Payer: BCN Medicare Advantage |
$103.32
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.32
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PACE Senior Care Partners |
$98.15
|
| Rate for Payer: PACE SWMI |
$103.32
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: PHP Medicare Advantage |
$103.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.54
|
| Rate for Payer: Priority Health Medicare |
$103.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.05
|
| Rate for Payer: Railroad Medicare Medicare |
$103.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.68
|
| Rate for Payer: UHC Core |
$345.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.32
|
| Rate for Payer: UHC Medicare Advantage |
$106.42
|
| Rate for Payer: VA VA |
$103.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
OP
|
$6,494.28
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,542.39 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna Medicare |
$1,688.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,029.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,029.46
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,623.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,049.30
|
| Rate for Payer: BCN Commercial |
$5,049.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,623.57
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,623.57
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,704.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,867.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,542.39
|
| Rate for Payer: PACE SWMI |
$1,623.57
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,623.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Medicare |
$1,623.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,623.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,623.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.28
|
| Rate for Payer: VA VA |
$1,623.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS
|
Facility
|
IP
|
$6,494.28
|
|
|
Service Code
|
CPT 47538
|
| Hospital Charge Code |
36100495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,960.86 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: BCBS Trust/PPO |
$5,018.78
|
| Rate for Payer: BCN Commercial |
$5,018.78
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
IP
|
$6,494.28
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,960.86 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: BCBS Trust/PPO |
$5,018.78
|
| Rate for Payer: BCN Commercial |
$5,018.78
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS
|
Facility
|
OP
|
$6,494.28
|
|
|
Service Code
|
CPT 47539
|
| Hospital Charge Code |
36100496
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,542.39 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna Medicare |
$1,688.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,029.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,029.46
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,623.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,049.30
|
| Rate for Payer: BCN Commercial |
$5,049.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,623.57
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,623.57
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,704.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,867.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,542.39
|
| Rate for Payer: PACE SWMI |
$1,623.57
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,623.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Medicare |
$1,623.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,623.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,623.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.28
|
| Rate for Payer: VA VA |
$1,623.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,494.28
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,960.86 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: BCBS Trust/PPO |
$5,018.78
|
| Rate for Payer: BCN Commercial |
$5,018.78
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
OP
|
$6,494.28
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,542.39 |
| Max. Negotiated Rate |
$5,844.85 |
| Rate for Payer: Aetna Commercial |
$5,520.14
|
| Rate for Payer: Aetna Medicare |
$1,688.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,029.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,029.46
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,623.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,049.30
|
| Rate for Payer: BCN Commercial |
$5,049.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,623.57
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cash Price |
$5,195.42
|
| Rate for Payer: Cofinity Commercial |
$5,585.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,195.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,623.57
|
| Rate for Payer: Healthscope Commercial |
$5,844.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.71
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,704.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,867.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,520.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,542.39
|
| Rate for Payer: PACE SWMI |
$1,623.57
|
| Rate for Payer: PHP Commercial |
$5,520.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,623.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,650.02
|
| Rate for Payer: Priority Health Medicare |
$1,623.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,960.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,623.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.97
|
| Rate for Payer: UHC Core |
$5,422.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,623.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.28
|
| Rate for Payer: VA VA |
$1,623.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.71
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$200.40
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$180.36 |
| Rate for Payer: Aetna Commercial |
$170.34
|
| Rate for Payer: Aetna Medicare |
$52.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.62
|
| Rate for Payer: BCBS Complete |
$80.16
|
| Rate for Payer: BCBS MAPPO |
$50.10
|
| Rate for Payer: BCBS Trust/PPO |
$155.81
|
| Rate for Payer: BCN Commercial |
$155.81
|
| Rate for Payer: BCN Medicare Advantage |
$50.10
|
| Rate for Payer: Cash Price |
$160.32
|
| Rate for Payer: Cofinity Commercial |
$172.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.10
|
| Rate for Payer: Healthscope Commercial |
$180.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.34
|
| Rate for Payer: PACE Senior Care Partners |
$47.60
|
| Rate for Payer: PACE SWMI |
$50.10
|
| Rate for Payer: PHP Commercial |
$170.34
|
| Rate for Payer: PHP Medicare Advantage |
$50.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.35
|
| Rate for Payer: Priority Health Medicare |
$50.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.22
|
| Rate for Payer: Railroad Medicare Medicare |
$50.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.35
|
| Rate for Payer: UHC Core |
$167.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.60
|
| Rate for Payer: VA VA |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.30
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$200.40
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.22 |
| Max. Negotiated Rate |
$180.36 |
| Rate for Payer: Aetna Commercial |
$170.34
|
| Rate for Payer: BCBS Trust/PPO |
$154.87
|
| Rate for Payer: BCN Commercial |
$154.87
|
| Rate for Payer: Cash Price |
$160.32
|
| Rate for Payer: Cofinity Commercial |
$172.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.32
|
| Rate for Payer: Healthscope Commercial |
$180.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.34
|
| Rate for Payer: PHP Commercial |
$170.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.35
|
| Rate for Payer: UHC Core |
$167.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.30
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$8,900.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,428.11 |
| Max. Negotiated Rate |
$8,010.00 |
| Rate for Payer: Aetna Commercial |
$7,565.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,877.92
|
| Rate for Payer: BCN Commercial |
$6,877.92
|
| Rate for Payer: Cash Price |
$7,120.00
|
| Rate for Payer: Cofinity Commercial |
$7,654.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,120.00
|
| Rate for Payer: Healthscope Commercial |
$8,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,675.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,565.00
|
| Rate for Payer: PHP Commercial |
$7,565.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,230.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,743.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,428.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,832.00
|
| Rate for Payer: UHC Core |
$7,431.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,675.00
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$8,900.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,113.75 |
| Max. Negotiated Rate |
$8,010.00 |
| Rate for Payer: Aetna Commercial |
$7,565.00
|
| Rate for Payer: Aetna Medicare |
$2,314.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,781.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,781.25
|
| Rate for Payer: BCBS Complete |
$3,560.00
|
| Rate for Payer: BCBS MAPPO |
$2,225.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,919.75
|
| Rate for Payer: BCN Commercial |
$6,919.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,225.00
|
| Rate for Payer: Cash Price |
$7,120.00
|
| Rate for Payer: Cofinity Commercial |
$7,654.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,225.00
|
| Rate for Payer: Healthscope Commercial |
$8,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,675.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,336.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,558.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,565.00
|
| Rate for Payer: PACE Senior Care Partners |
$2,113.75
|
| Rate for Payer: PACE SWMI |
$2,225.00
|
| Rate for Payer: PHP Commercial |
$7,565.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,225.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,230.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,743.00
|
| Rate for Payer: Priority Health Medicare |
$2,225.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,428.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,225.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,832.00
|
| Rate for Payer: UHC Core |
$7,431.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,225.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,291.75
|
| Rate for Payer: VA VA |
$2,225.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,675.00
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$324.72
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.12 |
| Max. Negotiated Rate |
$2,401.24 |
| Rate for Payer: Aetna Commercial |
$276.01
|
| Rate for Payer: Aetna Medicare |
$84.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.48
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$81.18
|
| Rate for Payer: BCBS Trust/PPO |
$252.47
|
| Rate for Payer: BCN Commercial |
$252.47
|
| Rate for Payer: BCN Medicare Advantage |
$81.18
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cofinity Commercial |
$279.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.18
|
| Rate for Payer: Healthscope Commercial |
$292.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.54
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.01
|
| Rate for Payer: PACE Senior Care Partners |
$77.12
|
| Rate for Payer: PACE SWMI |
$81.18
|
| Rate for Payer: PHP Commercial |
$276.01
|
| Rate for Payer: PHP Medicare Advantage |
$81.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.51
|
| Rate for Payer: Priority Health Medicare |
$81.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.05
|
| Rate for Payer: Railroad Medicare Medicare |
$81.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.75
|
| Rate for Payer: UHC Core |
$271.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.18
|
| Rate for Payer: UHC Medicare Advantage |
$83.62
|
| Rate for Payer: VA VA |
$81.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.54
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$324.72
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$198.05 |
| Max. Negotiated Rate |
$292.25 |
| Rate for Payer: Aetna Commercial |
$276.01
|
| Rate for Payer: BCBS Trust/PPO |
$250.94
|
| Rate for Payer: BCN Commercial |
$250.94
|
| Rate for Payer: Cash Price |
$259.78
|
| Rate for Payer: Cofinity Commercial |
$279.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.78
|
| Rate for Payer: Healthscope Commercial |
$292.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.01
|
| Rate for Payer: PHP Commercial |
$276.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.75
|
| Rate for Payer: UHC Core |
$271.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.54
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,571.86
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,178.48 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,760.33
|
| Rate for Payer: BCN Commercial |
$2,760.33
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.49
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,107.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.24
|
| Rate for Payer: UHC Core |
$2,982.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.90
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,571.86
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.32 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna Medicare |
$928.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.21
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$892.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,777.12
|
| Rate for Payer: BCN Commercial |
$2,777.12
|
| Rate for Payer: BCN Medicare Advantage |
$892.96
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.96
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.90
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$937.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PACE Senior Care Partners |
$848.32
|
| Rate for Payer: PACE SWMI |
$892.96
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: PHP Medicare Advantage |
$892.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,107.52
|
| Rate for Payer: Priority Health Medicare |
$892.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.48
|
| Rate for Payer: Railroad Medicare Medicare |
$892.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.24
|
| Rate for Payer: UHC Core |
$2,982.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.96
|
| Rate for Payer: UHC Medicare Advantage |
$919.75
|
| Rate for Payer: VA VA |
$892.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.90
|
|
